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生物电阻抗分析得出的相位角可预测维持性血液透析患者的肌肉减少症。

Bioelectrical impedance analysis-derived phase angle predicts sarcopenia in patients on maintenance hemodialysis.

机构信息

Department of Nephrology, Zhong da Hospital, Southeast University School of Medicine, Nanjing, China.

Department of Clinical Nutrition, School of Medicine, Southeast University, Nanjing, China.

出版信息

Nutr Clin Pract. 2023 Aug;38(4):881-888. doi: 10.1002/ncp.10967. Epub 2023 Feb 18.

Abstract

BACKGROUND

This study aimed to investigate the association between phase angle (PhA) and sarcopenia and evaluate its performance as a sarcopenia predictor in patients receveing maintenance hemodialysis (MHD).

METHODS

All enrolled patients underwent handgrip strength (HGS) and the 6-m walk test, and muscle mass was measured using bioelectrical impedance analysis. Sarcopenia was diagnosed according to the diagnostic criteria of the Asian Sarcopenia Working Group. Logistic regression analysis was used to evaluate the PhA as an independent predictor of sarcopenia after adjusting for confounding factors. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of PhA in sarcopenia.

RESULTS

Two hundred forty-one patients receiving hemodialysis were enrolled in this study, and the prevalence of sarcopenia was 28.2%. Patients with sarcopenia presented a lower PhA value (4.7° vs 5.5°; P < 0.001), lower muscle mass index (6.0 vs 7.2 [kg/m ]; P < 0.001), lower HGS (19.7 vs 26.0 [kg]; P < 0.001), and lower walk speed (0.83 ± 0.27 vs 0.92 ± 0.23 [m/s]; P = 0.007) than patients without sarcopenia. The odds of patients receiving MHD presenting with sarcopenia increased as PhA decreased, even after adjustment (odds ratio = 0.39; 95% CI, 0.18-0.85; P = 0.019). ROC analysis revealed that the best cutoff value of PhA for sarcopenia was 4.95° in patients receiving MHD.

CONCLUSION

PhA may be a useful and simple predictor for predicting patients undergoing hemodialysis who are at risk of sarcopenia. To further facilitate the application of PhA in the diagnosis of sarcopenia, more research need to be conducted.

摘要

背景

本研究旨在探讨相位角(PhA)与肌肉减少症的关系,并评估其作为维持性血液透析(MHD)患者肌肉减少症预测因子的性能。

方法

所有入组患者均行握力(HGS)和 6 米步行试验,使用生物电阻抗分析测量肌肉量。根据亚洲肌肉减少症工作组的诊断标准诊断肌肉减少症。在调整混杂因素后,采用 logistic 回归分析评估 PhA 作为肌肉减少症的独立预测因子。采用受试者工作特征(ROC)曲线分析 PhA 对肌肉减少症的预测价值。

结果

本研究共纳入 241 例接受血液透析的患者,肌肉减少症的患病率为 28.2%。患有肌肉减少症的患者 PhA 值较低(4.7° vs 5.5°;P<0.001),肌肉质量指数较低(6.0 vs 7.2 [kg/m];P<0.001),握力较低(19.7 vs 26.0 [kg];P<0.001),步行速度较慢(0.83±0.27 vs 0.92±0.23 [m/s];P=0.007)。即使在调整后,MHD 患者 PhA 越低,患肌肉减少症的可能性越高(比值比=0.39;95%可信区间,0.18-0.85;P=0.019)。ROC 分析显示,MHD 患者 PhA 预测肌肉减少症的最佳截断值为 4.95°。

结论

PhA 可能是预测接受血液透析患者发生肌肉减少症风险的有用且简单的预测因子。为了进一步促进 PhA 在肌肉减少症诊断中的应用,需要开展更多的研究。

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